Do you sometimes feel your heart beating faster and faster for no apparent reason? Do you feel like a bird is flapping its wings inside your chest? This is a really scary experience. This sudden increase in heart rate is called Supraventricular Tachycardia (SVT). In times like these, before resorting to medication, there is a simple but very useful method that can help you normalize your heart rate. Today we are talking about 'Vagal Maneuvers'.
Simply put, what are 'Vagal Maneuvers'?
Imagine that your body has a natural 'brake' that controls the speed of your heart. That brake is called the 'Vagus Nerve'. This is a long nerve that runs from our brain to our stomach. This nerve helps control many things, including the speed of our heart beat and breathing.
'Vegal maneuvers' are certain physical activities that we do intentionally. They stimulate the 'vagas nerve', which sends a signal to the heart's natural pacemaker, which slows down the heart rate. Simply put, these are some ways to use our body's natural 'brake' to calm down a fast-beating heart. This is something that is done under the supervision of a doctor. Do not try these on your own without talking to your doctor.
Why are these methods so important?
When treating someone with a rapid heart rate (SVT), doctors often use these 'vegal maneuvers' as their first choice . There are several reasons for this:
- Low risk: These methods are much less risky than giving medication or giving electrical shocks (cardioversion).
- Low cost: This does not require any special equipment or medication, so it is inexpensive.
- Quick results: If successful, the heart rate returns to normal within a few minutes. The success rate is usually between 20% and 40%.
- Diagnostic aid: Sometimes, by looking at how your heart responds to these methods, your doctor can determine exactly what type of heart rhythm disorder (arrhythmia) you have.
The main types of 'vegal maneuvers' used by doctors
There are several of these methods. The table below shows some of the methods most commonly used by doctors.
| Method Name | Simply explained |
|---|---|
| Valsalva Maneuver | Holding your breath and straining as if you are defecating. |
| Diving Reflex | Suddenly immersing the face in a bowl of ice water. |
| Carotid Sinus Massage | (Only by a doctor) Gently massaging a specific spot on the side of the neck. |
| Gag reflex | Stimulating the throat to induce vomiting. |
| Coughing | To have a loud, harsh cough. |
How do you do these methods?
Here's how to do three of the most commonly used methods. Remember, these are done under the supervision of a doctor.
- Valsalva Maneuver: You will be asked to lie down on a bed, take a deep breath, close your nose and mouth, and exhale for 10-30 seconds, as if you were trying to blow into a blocked pipe. Sometimes, the doctor may also tilt the head of the bed down and raise your legs as you exhale.
- Diving Reflex: While sitting, hold your breath and immerse your entire face in a basin of ice water. Keep your face in the water for as long as possible. Alternatively, you can hold an ice pack or a cold wet towel over your face.
- Carotid Sinus Massage: This is something that only a doctor can do. You will be laid down on the bed, your head turned to one side, and the doctor will gently press the area called the 'Carotid Sinus' on the side of your neck with his fingers for 5-10 seconds.
Who is this method not suitable for? (Risk factors)
These methods are not suitable for everyone. Doctors do not use these methods if a patient's condition is 'unstable', meaning if they have the following symptoms:
- Very low blood pressure(Low blood pressure)
- Chest pain
- Shortness of breath
- Not getting enough oxygen to the body
- A condition in which the organs do not receive enough blood
For such an unstable person, cardioversion, which controls the heartbeat with medication or an electric shock, is used instead of 'vagal maneuvers'.
Important: If you experience symptoms such as chest pain, shortness of breath, or rapid heartbeat, it is an emergency. Go to a hospital's Emergency Department (ETU) immediately.
Are there any risks with these methods?
Generally, complications are rare when a doctor performs this procedure on a suitable person. If they do occur, most of them are temporary.
- Low blood pressure (Hypotension)
- Excessively slow heartbeat (Bradycardia)
- Other heart rhythm disorders that can occur very rarely include Atrial Fibrillation, Ventricular Fibrillation, and Ventricular Tachycardia.
In particular, the method called 'Carotid Sinus Massage' cannot be done by everyone. It should not be done by people with the following history:
- For those who have had a previous stroke or TIA (transient ischemic attack)
- For those with carotid artery disease
- For those who have recently had a heart attack
- For children under 10 years old
This is why we repeat, never try these methods, especially the neck massage method, on your own without the advice of a doctor.
Take-Home Message
- 'Vegal maneuvers' are simple physical exercises used to control a sudden increase in heart rate (SVT).
- Doctors use these as the first line of treatment because they are less risky.
- Do not attempt these at home unless instructed by your doctor. Carotid Sinus Massage in particular should only be performed by a doctor.
- If you have chest pain, dizziness, or difficulty breathing while your heart is beating fast, go to a hospital's Emergency Department (ETU) immediately.
- If these methods don't control your heart rate, don't panic. Your doctor may have medication or other treatments (e.g., catheter ablation). Always follow his or her instructions.
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